As a general rule, Medicare doesn’t cover walk-in tubs but could be eligible for reimbursement with a doctor’s prescription demonstrating medical necessity.
However, Medicare does not classify a walk-in tub as Durable Medical Equipment (DME) under Medicare Part B. Still, some people with limitations or older can obtain a doctor’s prescription and claim it.
Does Medicare cover walk-in tubs?
According to Original Medicare, Part A (hospital insurance) and Part B (medical insurance) typically do not cover the cost of walk-in tubs.
Since these tubs are considered home modifications rather than medical devices, they fall outside the scope of Medicare’s coverage.
Medicare Part C, or Medicare Advantage, is a privately offered alternative to Original Medicare. It may cover walk-in tubs if they are deemed medically necessary.
To qualify, your doctor must prescribe the walk-in tub and demonstrate that it is essential for improving your health or preventing further illness.
A plethora of different medical items belong to the group considered durable equipment.
Medicare program usually reimbursement for the following items:
- Special chairs
- Patient lift
- Adjustable bed (hospital-style)
- Special commodes
In fact, all these pieces are in place so that seniors can use a walk-in tub shower easily and safely.
Medicare is designed to assist individuals with lower incomes and those who face obstacles in accessing healthcare.
Certain medical conditions, undocumented immigrants, and individuals who are blind or disabled may not qualify for coverage through private insurance markets in their states. In such cases, they might consider enrolling in Medicare, depending on their financial circumstances and the specific resources available in their state.
Coverage through a Medicare Advantage plan
Medicare can cover walk-in tubs if you provide a medical diagnosis detailing the beneficiary’s need and the medical reasons for the necessity.
You never will receive an upfront payment, but maybe you can get a reimbursement. So it’s never guaranteed that they will pay.
Before 2018, Medicare did not cover surgical supplies for men or women aged 55 and older. Now, it does.
In general, one has to try it to benefit from using a walk-in tub, which is durable medical equipment. In this regard, a medical diagnosis will substantiate the needs of the enthusiastic beneficiary.
A medical report showing a diagnosis or a prescription written by a registered physician may serve the purpose well.
The doctor must pass you a letter of medical necessity for the walk-in tub.
The prescription or diagnostic report should outline authentic reasons for getting a walk-in tub.
Gathering all the above supportive documents does not necessarily mean that Medicare guarantees its assistance.
It can be best to take the walk-in tub as an out-of-pocket possession, which means that people should look for other sources of financial assistance.
People should prefer to prepare to bear the cost personally after submitting a claim and getting approved to wait for the best support.
The only thing that can be said is that support is unavailable before purchasing such tubs.
Rather, the support is provided in the form of pay, yet these excellent tubs would be considered a medical necessity. Well, it is simply a home modification that Medicare is unwilling to cover. Such installation does not mean any addition but an absolute modification at a specific place in the house.
Coverage for Installation Costs
Medicare typically only reimburses the total purchase price of the walk-in tub, excluding installation costs. The price of a walk-in tub ranges between $2,500 and $25,000, and the installation cost ranges from $1,000 to $3,000, which is usually not covered.
They rarely pay the installation costs and other modifications at home that you may need to fit your walk-in tub in your bathroom, like accessibility modifications.
For those with balance or mobility issues, stepping over the edge of a high bathtub into hot water can be difficult without risking injury. Tubs come equipped with safety features, such as seats, that allow users to take advantage of all their benefits while keeping themselves safe.
Financial Assistance for Walk-In Tubs
Medicaid
If you meet the eligibility requirements for Medicaid, your state’s program may provide financial assistance for purchasing a walk-in bathtub.
Veterans Assistance
Veterans Assistance may support the acquisition of a walk-in tub, but this typically comes as a grant rather than VA insurance coverage. Obtaining financial assistance for a walk-in tub may be challenging if you’re a veteran enrolled in TRICARE or CHAMPVA insurance schemes. However, home modification grants for veterans requiring a walk-in bathtub are feasible. Not all these grants are linked to military service, so veterans needing medical devices due to age-related needs could secure financial help. Remembering this isn’t a universal rule, so before purchasing a walk-in tub, ensure you qualify for the grant.
Private insurance
Some private insurance plans may include coverage for walk-in tubs. Review the terms and conditions of your policy or contact your insurance provider to ascertain if this benefit is available to you.
Financial assistance programs
Numerous financial assistance programs are available to help individuals pay for walk-in tubs. These programs are frequently funded by state or local governments and charitable organizations. Exploring these programs could help alleviate the financial burden of acquiring a walk-in tub.
It is crucial to thoroughly research and explore all available options to determine the most suitable and cost-effective way to obtain a walk-in tub that meets your needs.
Agriculture department grant
USDA Rural Development provides a grant to assist low-income seniors who own homes in carrying out home improvements and repairs. This grant could potentially cover the installation of a walk-in bathtub.
Tax deduction
Medicare is a federal health insurance program administered by the U.S. Department of Health and Human Services (HHS). One of the most influential brands of walk-in tubs is American Standard starts at $4,000 up to $12,000.
If you are a disabled veteran, please check out this article.
Sources
- CMS finalizes Medicare Advantage and Part D payment and policy updates to maximize competition and coverage. (2019).
https://www.cms.gov/newsroom/press-releases/cms-finalizes-medicare-advantage-and-part-d-payment-and-policy-updates-maximize-competition-and - Durable medical equipment (DME) coverage. (n.d.).
https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage - Single-family housing repair loans and grants. (n.d.).
https://www.rd.usda.gov/programs-services/single-family-housing-repair-loans-grants - What does Part B of Medicare (medical insurance) cover? (2014).
https://www.hhs.gov/answers/medicare-and-medicaid/what-does-medicare-part-b-cover/index.html - What is Medicare Part A? (2014).
https://www.hhs.gov/answers/medicare-and-medicaid/what-is-medicare-part-a./index.html
